If you are experiencing problems downloading PDF or HTML fulltext, our helpdesk recommend clearing your browser cache and trying again. If you need help in clearing your cache, please click here . Still need help? Email help@ingentaconnect.com

Free Content Shifting the balance between in-patient and out-patient care for tuberculosis results in economic savings

 Download
(PDF 63.8kb)
 
Download Article:

Abstract:

SETTING: Although hospitalisation is not always necessary for the treatment of tuberculosis (TB), in Australia 90% of TB patients have treatment initiated in hospital.

OBJECTIVE: To calculate and compare the costs of in-patient and out-patient tuberculosis treatment, and to measure the impact of shifting care from in-patient to out-patient settings.

METHODS: In a costing study performed in Victoria, Australia, the proportion of all notified TB cases who were hospitalised was calculated by matching coded state hospital morbidity data with the Victoria Notifiable Diseases database for the financial year 1994–1995. In-patient and out-patient costs were calculated using data obtained from a number of sources. The effect on health care costs of varying the proportion of TB cases treated as in-patients and out-patients was calculated using Excel.

RESULTS: Nearly 90% (239/269) of notified TB cases received hospitalised care in 1994–1995. The cost of treatment for hospitalised patients (mean length of stay 2 weeks) was AU$5447 per patient, with a total cost of $1301833. Hospitalisation comprised 60% of the total cost of treatment. The cost of out-patient treatment was $2260 per patient. If 90% of patients were treated on an out-patient basis, the total cost would be $693670. We estimated that it would be feasible to treat at least 55% of TB patients as out-patients, reducing costs by nearly 30%.

CONCLUSIONS: Routine hospitalisation for patients with uncomplicated TB is not necessary, but is often used in industrialised countries. More cost-effective use of resources can be achieved by giving initial TB treatment on an out-patient basis rather than in hospital for a greater proportion of cases.

Keywords: cost; hospitalisation; out-patient; resources; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Victorian Infectious Diseases Service, the Royal Melbourne Hospital, Parkville, Victoria, Australia 2: Faculty of Nursing, Curtin University, Western Australia 3: Department of Public Health, University of Western Australia, Nedlands, Western Australia, Australia

Publication date: March 1, 2001

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • ingentaconnect is not responsible for the content or availability of external websites
Related content

Tools

Favourites

Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more